de Vries Hilbert S, Samlal Raoul K, Maresch Bas J, Hoven-Gondrie Miriam L
Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands.
Department of Gyneacology, Gelderse Vallei Hospital, Ede, The Netherlands.
Int J Surg Case Rep. 2015;10:97-9. doi: 10.1016/j.ijscr.2015.03.021. Epub 2015 Mar 13.
Cecal volvulus is a relatively uncommon encountered clinical condition.
A 48-year-old patient known with a large uterine leiomyoma, presented with progressive abdominal pain since one week. An abdominal computed tomography scan revealed a very large leiomyoma of the uterus, severely distended loops of the small bowel with a caliber change and a suggested 'whirl sign' of the mesenteric vessels. A laparotomy was performed, showing a very large uterus as well as torsion of the mesentery of the cecum with a sharp demarcated area of necrosis of the right hemicolon.
Cecal volvulus due to a large uterine mass is a rare encountered clinical entity. The suggested mechanism might be the same mechanism causing cecal volvulus during pregnancy; the enlarged uterus raisingout the mobile cecum out of the pelvis. Obstruction may occur from kinking of the colon at a fixed point.
This case demonstrates that uterine leiomyoma can be a cause of a cecal volvulus, leading to severe intestinal strangulation.
盲肠扭转是一种相对罕见的临床病症。
一名48岁女性患者，已知患有巨大子宫平滑肌瘤，自一周前开始出现进行性腹痛。腹部计算机断层扫描显示子宫有一个非常大的平滑肌瘤，小肠肠袢严重扩张，管径改变，肠系膜血管呈现“漩涡征”。进行了剖腹手术，发现子宫非常大，同时盲肠系膜扭转，右半结肠有一个界限清晰的坏死区域。
由巨大子宫肿物导致的盲肠扭转是一种罕见的临床情况。推测其机制可能与孕期导致盲肠扭转的机制相同；增大的子宫将活动的盲肠带出盆腔。结肠在固定点处扭结可能会导致梗阻。
本病例表明子宫平滑肌瘤可能是盲肠扭转的一个病因，可导致严重的肠绞窄。
